II. Pharmacokinetics

  1. Purified capsular polysaccharide antigens from 23 serotypes
  2. These serotypes are responsible for 88% of invasive pneumococcal disease

III. Indications: Adult Vaccine

  1. Age 65 years and older
  2. Sickle Cell Disease
  3. Functional or anatomic Asplenia
    1. Administer 2 weeks prior to splenectomy
  4. Nephrotic Syndrome or Chronic Renal Failure
  5. Immunosuppression
  6. Human Immunodeficiency Virus
  7. Heart, lung or liver disease
  8. Asthma
  9. Tobacco users (starting at age 50 years)
  10. High risk environments
    1. Native American Reservations
    2. Nursing Homes

IV. Indications: Children (age 2 years and older)

  1. Chronic illness (including Corticosteroid dependent Asthma)
  2. Functional Asplenia or anatomic Asplenia
  3. Immunocompromised state
  4. Renal disease (e.g. Nephrotic Syndrome, Renal Failure)

V. Dosing

  1. One dose is sufficient for most patients at age 65 years
  2. Indication for single dose ages 2 to 64 years
    1. See Indications above
    2. Give a second dose at age 65 or at least 5 years after the last dose
  3. Indication for 2 doses at more than 5 years apart at ages 2 to 64 years
    1. Give third dose at age 65 years or at least 5 years after the last dose
    2. Chronic renal disease (Renal Failure, Nephrotic Syndrome)
    3. Asplenia
    4. Sickle Cell Anemia
    5. Immunocompromised state
      1. HIV Infection
      2. Leukemia
      3. Lymphoma
      4. Multiple Myeloma
      5. Iatrogenic (e.g. organ transplant, Radiation Therapy, Chemotherapy)
  4. Timing with Prevnar 13 (recommended as of 2012 for immunocompromised adults)
    1. No prior Pneumovax or immunocompromised state
      1. Give Pneumovax 23 at least 8 weeks after Prevnar 13
    2. Prior Pneumovax
      1. Give Prevnar 13 at least one year after Pneumovax 23
  5. Schedule for those over age 65 years
    1. No prior Pneumovax 23
      1. Prevnar 13 after age 65 year birthday AND
      2. Pneumovax 23 at 6-12 months after Prevnar 13 dose (8 weeks if immunocompromised)
    2. Prior Pneumovax 23 after age 65 year birthday
      1. Prevnar 13 after age 65 year birthday
      2. No further Pneumovax 23 needed
    3. Prior Pneumovax 23 before age 65 year birthday
      1. Prevnar 13 after age 65 year birthday AND at least one year after Pneumovax 23 AND
      2. Pneumovax 23 at 12 months after Prevnar 13 dose AND 5 years after last Pneumovax 23
    4. References
      1. (2014) Presc Lett 21(11): 63-64

VI. Precautions

  1. Administer to high risk women before pregnancy
  2. ACIP recommends avoiding in pregnancy
  3. Pneumococcal Vaccine may be given on same day as other Vaccines (e.g. Influenza Vaccine, Shingles Vaccine)
    1. PrevnarVaccine may have reduced Antibody response when given with Influenza Vaccine
    2. However, given both Vaccines (Prevnar and Influenza) does not reduce their efficacy

VII. References

  1. Presc Lett 22(11): 63

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Ontology: Pneumovax (C0071315)

Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D022242
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English pneumovax, Pneumovax

Ontology: Polyvalent pneumococcal vaccine (C0305065)

Definition (HL7V3.0) <p>pneumococcal polysaccharide vaccine</p>
Definition (NCI) An polyvalent vaccine used to prevent infection by the bacterium Streptococcus pneumoniae. Pneumococcal polyvalent vaccine contains highly purified capsular antigens from the 23 most prevalent or invasive pneumococcal types of Streptococcus pneumoniae to ensure cross-protection. Following vaccination, protective capsular type-specific antibody levels typically develop by the third week; serotype-specific antibody levels generally decline after 5-10 years.
Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D022242
SnomedCT 70447008, 135642004, 417011002
HL7 109, 33
English pneumococcal polyvalent vaccine, pneumococcal polysaccharide vaccine, pneumococcal polysaccharide vaccine (medication), Pneumococcal Polysaccharide Vaccine [Chemical/Ingredient], Polysaccharide Vaccine, Pneumococcal, Vaccine, Pneumococcal Polysaccharide, PPSV, Polyvalent pneumococcal vaccine, Pneumococcal polysaccharide vaccine (product), Pneumococcal polysaccharide vaccine, Polyvalent pneumococcal vaccine (product), Polyvalent pneumococcal vaccine (substance), Pneumococcal Polyvalent Vaccine, Pneumococcal Polysaccharide Vaccine, pneumococcal, NOS, pneumococcal, Pneumococcal polysaccharide vaccine (substance), PNEUMOCOCCAL POLYSACCHARIDE VACCINE, Pneumococcal Vaccine Polyvalent
Czech pneumokoková polysacharidová vakcína
Portuguese Vacina de Polissacarídeo de Pneumococos
Spanish Vacuna Polisacarida Neumococica, vacuna antineumocócica polisacárida (producto), vacuna antineumocócica polisacárida, vacuna antineumocócica polivalente (producto), vacuna antineumocócica polivalente (sustancia), vacuna antineumocócica polivalente, vacuna de polisacárido neumocócico (sustancia), vacuna de polisacárido neumocócico
French Vaccin antipneumococcique polysaccharidique, Vaccin pneumococcique polysaccharidique
German Pneumokokken-Polysaccharid-Vakzine, Pneumokokken-Polysaccharid-Impfstoff

Ontology: Pneumococcal vaccine (C0358314)

Definition (NCI) A bacterial vaccine used to prevent contraction of Streptococcus pneumonia.
Definition (MSH) Vaccines or candidate vaccines used to prevent infections with STREPTOCOCCUS PNEUMONIAE.
Definition (CSP) vaccine or candidate vaccine used to prevent infections with Streptococcus pneumoniae.
Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D022242
SnomedCT 333598008, 398730001
LNC MTHU021223
English Pneumococcal vaccine, Pneumococcal Vaccine, Streptococcus pneumoniae vaccine, PNEUMOCOCCAL VACCINE, Pneumococcal Vaccines [Chemical/Ingredient], pneumococcal vaccine (medication), pneumococcal vaccine, pneumococcal vaccines, pneumoniae streptococcus vaccines, pneumoniae streptococcus vaccine, streptococcus pneumoniae vaccine, Pneumococcal Vaccines, Vaccines, Pneumococcal, Streptococcus pneumoniae Vaccine, Pneumococcal vaccines, Pneumococcal vaccine (product), Pneumococcal vaccine (substance)
Swedish Pneumokockvacciner
Spanish vacuna neumocócica, vacuna antineumocócica (sustancia), vacuna antineumocócica, vacuna anti-neumocóccica, vacuna antineumocócica (producto), vacuna neumocócica (producto), vacuna neumocócica (sustancia), Vacunas Neumococicas
Czech pneumokokové vakcíny
Finnish Pneumokokkirokotteet
Russian VAKTSINY PNEVMOKOKKOVYE, PNEVMOKOKKOVYE VAKTSINY POLISAKHARIDNYE, ВАКЦИНЫ ПНЕВМОКОККОВЫЕ, ПНЕВМОКОККОВЫЕ ВАКЦИНЫ ПОЛИСАХАРИДНЫЕ
Japanese ワクチン-肺炎球菌, 肺炎球菌多糖類ワクチン, 肺炎球菌ワクチン, 多糖類ワクチン-肺炎球菌
Polish Szczepionki przeciw zakażeniu pneumokokami, Szczepionki przeciw pneumokokom, Szczepionki przeciw pneumokokom polisacharydowe
Portuguese Vacinas contra Streptococcus Pneumoniae, Vacinas Pneumocócicas
French Vaccins antipneumococciques, Vaccins contre le pneumocoque, Vaccins pneumococciques
German Impfstoffe, Pneumokokken-, Pneumokokkenimpfstoffe, Pneumokokkenvakzinen
Italian Vaccini pneumococcici

Ontology: Pneumovax 23 (C0947642)

Concepts Pharmacologic Substance (T121) , Carbohydrate (T118) , Immunologic Factor (T129)
English Pneumovax 23, Pneumovax 23 (obsolete)